To kick things off, we need to understand how two important organs — namely, your liver and gallbladder — function under normal conditions first.

How Your Liver and Gallbladder Work Together

The relationship between your liver and gallbladder is a special one.

While your liver and gallbladder work together, they serve very different purposes.

Your liver produces bile, a thick fluid that helps your body digest food and eliminate waste[*]. Bile is especially useful for breaking down fats in your diet so they become a form of energy your body can absorb and use.

Your gallbladder is where that excess bile is stored.

So, under normal conditions, your liver produces bile when food reaches your small intestine to help break down what you eat and drink.

If your liver produces more bile than your small intestine needs, it sends the excess straight to your gallbladder.

This also happens when you fast: bile is immediately sent to your gallbladder for storage since there’s nothing to break down.

When it’s time to eat again, your body sends out important hormones to signal your gallbladder to start delivering that stored bile.

So if you need this extra bile to help you properly digest the fats and other foods in your diet, that leads to the question:

What Happens When Your Gallbladder is Removed?

Once your gallbladder is removed from the equation, the digestion process looks a little different towards the end.

Your liver will still produce bile, but now it has nowhere to store it.

So instead of dumping a large amount of bile all at once, knowing that whatever isn’t used can’t be stored, your liver portions out much smaller amounts.

This means bile is released a little at a time to your small intestine.

The problem is that your liver may have a hard time sending the right amount of bile to complete the job, especially if you’re transitioning to a keto diet or you’ve just had your gallbladder removed.

When this happens, your body may not have enough bile to properly digest meals that contain a higher amount of fat, which is pretty much every day on a ketogenic diet.

If fats aren’t properly digested, your body won’t take in all the essential nutrients found in them.

You could end up deficient in critical fat soluble nutrients — such as vitamins K, A, D and E — since your body will be unable to absorb them from the foods you eat.

So does that automatically mean someone without a gallbladder can’t eat high fat meals or follow a keto diet?

Is It Possible to Do Keto Without a Gallbladder?

The good news is you don’t have to swear off healthy fats and you can still follow a keto diet even without your gallbladder.

But you’ll need to make some important adjustments or you’ll experience the malabsorption issue I just talked about.

You may also experience diarrhea, which further depletes your body of important nutrients, this time electrolytes.

To avoid those uncomfortable side effects, keep these tips in mind if ketosis is your goal.

Six Ways to Follow a Keto Diet If Your Gallbladder Was Removed

Practice these six strategies everyday and you should be able to safely enjoy being on a keto diet, with your doctor’s approval of course.

1. Ease Into Keto and Reduce Your Carbs Slowly

It doesn’t matter if you’ve recently removed your gallbladder or it’s been gone for over a decade, it’s still crucial you take a much slower approach to the keto transition than most people would.

Aiming for fast results by adding too many fats or cutting too many carbs at once may lead you straight towards malabsorption as it can put too much strain on your system.

So instead of completely transitioning to keto overnight, you should start one meal at a time, per day.

On day one, for example, you might add a little more fat to your breakfast or lunch while swapping out a few carbs, like the sugar you normally add to your coffee or removing the top slice of your sandwich at lunch.

Then see how your body reacts before adding additional fats to another meal.

If your stools don’t change much, you can try adding a little bit more fat to your meals the following day.

However, if you experience digestional upset, you may need to cut your fat intake in half before you start adding more to other meals.

Another trick that may help is noshing on carb sources that specifically increase your bile production, such as beets and apples, as you start to introduce more fats to your diet.

These foods can also help your body digest your increased fat intake.

The same happens when you follow this next tip.

2. Pair Your Fats with Soluble Fiber

When you add more fats to your meals and you notice your stools becoming greasy or oily, there’s a good chance your body is unable to digest all the fats you’re eating.

But before you decide to forgo keto, you may need to try eating your fats with soluble fiber instead[*].

Found in nuts, seeds and veggies, this type of fiber pulls water into the digestion process and turns it into a gel-like substance to help your body break down food and fat properly[*][*].

So by pairing your meals containing more fat with some soluble fiber, you may be able to help your body safely transition and stay in ketosis.

3. Help Your Body Digest Foods Properly

The more bile your liver produces, the easier time your body will have breaking down your additional fat intake.

Two more ways to do just that include using digestive enzymes and ox bile.

These supplements both trigger your body’s own stomach enzymes and bile to get to work on the foods you eat. This means they’re effectively digested and all the nutrients from your meals are absorbed.

This next tip is one you may not have considered, but it’s just as essential as the rest.

4. Stay Hydrated, With One Exception

You’ve probably already heard how important it is to drink water, but if you’re doing so just before or after your meals, you’re not doing your body any favors.

See, when you drink liquids with or around meals, you’re actually flushing out your body’s own digestive enzymes.

These guys show up to break down the food you’re eating, but once you take a few sips of water with your meal, you’re essentially washing them right down your intestinal tract before they can get to work.

To make sure you don’t do this, avoid drinking liquids with your meals and 30 minutes before and after them.

Making this next switch can also create a big difference too.

5. Opt for Medium Chain Fatty Acids Over Long Chain Ones

Most people don’t have to worry about which fatty acids to eat just as long as they’re getting a healthy balance of both medium and long chain.

But when it comes to people without their gallbladder, this isn’t the case.

See, long-chain fatty acids, such as those found in milk, beef and egg yolks, for example, are much harder to digest and require more bile to process.

For someone without a gallbladder, this is a lot of work and it may not be properly completed, leading to fat malabsorption.

A less taxing way to get in your essential fats without causing more work for your body is to choose medium-chain fatty acids, such as those found in grass-fed butter and coconut fats.

With a shorter chain to break down, your body doesn’t need as much bile and it has a better chance of absorbing the nutrients found in these foods since it can actually break them down properly.

Using pure MCT oil from coconuts is another efficient way to help your body break down the fats you eat while also boosting your ketone levels.

This is because MCT oil doesn’t require any bile to be properly digested and absorbed, which means it’s even less work for your body.

At least early on in your keto journey, you should avoid the long chain fatty acids found in nuts, seeds, avocados, olives and meats until your body adjusts.

Reach for foods packed with medium-chain fatty acids such as the ones found in grass-fed butter and MCT oil instead.

The last tip on this list is one that’s both convenient and full of nutrition.

6. Supplement With Nutritional Shakes

If it’s not abundantly clear yet, the idea here is to make eating fats less taxing on your body so it can properly digest the increased fat intake that comes with a keto diet.

One easy way to get a whole bunch of nutrients in your body without making it work too hard is using smoothies and nutritional shakes.

Because your supplement powder and blender or shaker bottle does all the work of breaking down the food and nutrients into a readily available form, your body can just absorb what’s being taken in without having to process it first.

But that’s only if you choose the right smoothies and shakes.

The sugar-packed ones you’ll find in stores and at juice bars — you know, the ones that contain five or six fruits and 40g+ of sugar per bottle — are not the ones I’m referring to here.

Instead, consider making your own smoothies so you can cut down on both the sugar and carbs of traditional options.

They’re super easy to whip up and they can last in your refrigerator for up to 24 hours (12 hours for a juice)[*]. That means you can make two at once and have tomorrow’s ready to go today.

You can also use a keto-friendly protein powder packed with collagen and MCTs to create a satiating shake that keeps you feeling good throughout the day.

Keto Without a Gallbladder: It Is Possible With Minor Adjustments

By keeping these six tips in mind, you may be able to enjoy a keto diet safely even if your gallbladder was removed.

You’ll want to pay very close attention to how your body is digesting your food. If you see signs your body is struggling to process the increased fat intake of a ketogenic diet, you’ll need to tweak your process and make slight adjustments.

Please be sure to speak with your doctor about trying a ketogenic diet for your specific situation first. And if you’re cleared for take off, check out the ultimate guide to starting keto next.

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Responses (3)

Liesl Bellsays:

Hello,

Is Ox Bile helpful, as well? I have been taking Now Super Enzymes but there are only 100mg Ox Bile in these; wondering if I higher dose would make a difference? (I am in the bathroom at least 3-4 times every morning.)